The hygiene hypothesis, first proposed in 1989, suggested that reduced exposure to infections in early life leads to allergic diseases by the defects in the establishment of immune tolerance. Although many studies provided evidence that some exposure conditions, including family size, antibiotics, probiotics, and viral or bacterial infections, are strongly related to the prevalence of allergic diseases, thereby supporting the hygiene hypothesis, some evidence does not provide acceptable results for the hygiene hypothesis. Further, most studies have focused on patients with asthma or atopic dermatitis, not allergic rhinitis. In this review, we summarize the recent studies for and against the ‘hygiene hypothesis’ and identify causal association with the prevalence of allergic rhinitis.

Allergen immunotherapy (AIT) has been used for over a century and has been demonstrated to be effective in treating patients with various allergic diseases. AIT allergens can be administered through various routes, including subcutaneous, sublingual, intralymphatic, oral, or epicutaneous routes. Sublingual immunotherapy (SLIT) has recently gained clinical interest, and it is considered an alternative treatment for allergic rhinitis (AR) and asthma. This review provides an overview of the current evidence-based studies that address the use of SLIT for treating AR, including (1) mechanisms of action, (2) appropriate patient selection for SLIT, (3) the current available SLIT products in Korea, and (4) updated information on its efficacy and safety. Finally, this guideline aims to provide the clinician with practical considerations for SLIT.

Allergen immunotherapy (AIT) is a causative treatment of allergic diseases in which allergen extracts are regularly administered in a gradually escalated doses, leading to immune tolerance and consequent alleviation of allergic diseases. The need for uniform practice guidelines in AIT is continuously growing as the number of potential candidates for AIT increases and new therapeutic approaches are tried. This updated version of the Korean Academy of Asthma Allergy and Clinical Immunology recommendations for AIT, published in 2010, proposes an expert opinion by specialists in allergy, pediatrics, and otorhinolaryngology. This guideline deals with the basic knowledge of AIT, including mechanisms, clinical efficacy, allergen standardization, important allergens in Korea, and special consideration in pediatrics. The article also covers the methodological aspects of AIT, including patient selection, allergen selection, schedule and doses, follow-up care, efficacy measurements, and management of adverse reactions. Although this guideline suggests the optimal dosing schedule, an individualized approach and modifications are recommended considering the situation for each patient and clinic.

Purpose: The purpose of this study was to compare the positive outcomes of fixed night shift, such as fatigue recovery experiences, work-life balance, and retention intentions, among nurses who had experienced both rotating shifts and fixed night shift. Methods: A single-cohort pre-post study design was used to compare the fatigue recovery experience, work-life balance, and retention intentions of nurses who have experienced fixed night shift. The study included 59 nurses working at a single university hospital in Seoul from September 1, 2023, to December 31, 2023. Data were analyzed using frequency and percentage, mean and standard deviation, t-test and ANOVA, paired t-test using the R statistical program. Results: The results revealed that acute and chronic fatigue levels decreased among nurses of night shifts during fatigue recovery assessment.However, the inter-shift recovery score did not improve, indicating that nurses' fatigue recovery was insufficient. Work-life balance scores increased, particularly in the area of work-leisure balance. Retention intention also improved among nurses of fixed night shift, but this was not statistically significant. Conclusion Based on the results of this study, the successful establishment of a fixed night shift system will reduce the turnover rate of the next generation of nurses and create a medical environment where nurses can spend more time on direct patient nursing care. Furthermore, we hope to improve the quality of life of nurses and improve the health outcomes of patients.